Hey! so i have now been off orientation for about 4.5 weeks. tonight was my first rapid response ever. it was really scary and i kinda cant believe it. basically the short story is i have report on a pt and she is late 70's who broke a few ribs on the left side. when i arrive im told she has been SOB all night and day. so i check on her and yes she is in fact sob. but not too significant she is a+0x3 and is pleasant able to tell me she is doing ok and will let me know if she is having a more difficult time. well i kinda had a bad feeling about her from the moment i looked at her but had nothing else to really base it on. flash forward now to 7pm. she has gotten an order for xanax for her agitation (her o2 sat was 97%). i had her on a venti mask 50% 02 and she was doing well. breathing through her mouth a lot. id been checking on and shes been doing ok. now to 845. i go into her room she is naked, agitated, and her face is beet red. call the rapid response. the doctor comes in decides its the medications she was given (also got 1mg of morphine for pain). so shes now on a rebreather and oxygenating well at 98%. he tells me to "do abg's if she desats again otherwise dont bother".
well now im feeling ok. shes oxygenating well. so give me like 15 mins and im uneasy again. clinically shes doing ok. but physically i believe shes struggling. so i put in the order frm the doc for the abgs. the doctor comes back up after i called him saying i thought she looked bad and the resp therapists could not get the abgs. he comes and does them. snaps at me about the portable chest. just all around cranky. now its 1030. he gets the abgs and says "so and so is taking over at 11 call him with this problem"
the portable chest gets done and it turns out her left lung is basically nil. pt is transferred up to the icu and intubated. omg.
this was my first ever rapid response and i feel as if ive run a marathon! of course since it was my first i was so caught up in looking after her i forgot to call family (which i apologized for but live and learn)! i just feel really sad because she had been ok earlier in the day. it all happened so fast. thank god other nurses were there to help! i know it takes a while to know just how to get it all done (proper charting and what not) but i guess i just get so wrapped up in making sure shes doing ok the other stuff gets behind. this job is so hard sometimes. like today. i learned a lot from it i guess. for next time. and there will def be a next time. i feel like i did the best i could and really what else matters other than that?
when they looked at the xray her xray was worse from the day before so this had all been building up from the night before. basically with the hernia on the diaphragm the pts stomach and intestines were up in her chest so the new doctor didnt want to put in a chest tube because he didnt know what he was going to get into. so they were doing a cat scan after they intubated her.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
when they looked at the xray her xray was worse from the day before so this had all been building up from the night before. basically with the hernia on the diaphragm the pts stomach and intestines were up in her chest so the new doctor didnt want to put in a chest tube because he didnt know what he was going to get into. so they were doing a cat scan after they intubated her.
sick lady......:redpinkhe. my prayers for her...:redpinkhe
katielam616
30 Posts
when they looked at the xray her xray was worse from the day before so this had all been building up from the night before. basically with the hernia on the diaphragm the pts stomach and intestines were up in her chest so the new doctor didnt want to put in a chest tube because he didnt know what he was going to get into. so they were doing a cat scan after they intubated her.